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Obesity Surgery
Published in: Obesity Surgery 9/2010

01-09-2010 | Clinical Research

Graft Survival and Complications after Laparoscopic Gastric Banding for Morbid Obesity—Lessons Learned from a 12-Year Experience

Authors: Markus Naef, Wolfgang G. Mouton, Ursula Naef, Oliver Kummer, Beat Muggli, Hans E. Wagner

Published in: Obesity Surgery | Issue 9/2010

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Abstract

Laparoscopic adjustable gastric banding (LAGB) has been considered by many as the treatment of choice for morbid obesity because of its simplicity and encouraging early results. The aim of this prospective study was to critically assess the effects, complications, and outcome after LAGB in the long-term, based on a 12-year experience. Between June 1998 and June 2009, all patients with implantation of a LAGB have been enrolled in a prospective clinical trial. Results were recorded and classified, with special regard to long-term complications, re-operation rate, and graft survival. LAGB was performed in 167 patients (120 female, 47 male) with a mean age of 40.1 ± 5.2 years. Operative mortality was 0%, overall 1.2% (not band-related). Overall patient follow-up was 94.0%. Mean excess weight loss (EWL) after 1, 2, 5, 8, and 10 years was 31.1 ± 7.5% (p < 0.005), 44.2 ± 6.5% (p < 0.001), 50.3 ± 6.9% (p < 0.001), 51.7 ± 6.3% (p < 0.001), and 48.8 ± 6.0% (p < 0.001), respectively. The non-responder rate (EWL < 30%) after 2, 5, 8, and 10 years was 24.5%, 18.3%, 12.5%, and 16.6%, respectively. The early complication rate (<30 days) was 7.8% (13/167), with 10 minor and three major complications. Late complications (>30 days) occurred in 40.1% (67/167), of whom seven were minor and 60 were major complications (three band infections, two band migrations, 11 band leakages, two slippings/pouch dilatations, two band intolerances, and 40 esophageal dilatations). The overall re-operation rate was 20.4% (34/167). The graft survival of the implanted band after 2, 5, 8, 10, and 12 years was 98.8%, 94.0%, 86.8%, 85.0%, and 85.0%, respectively. The failure rate of the procedure after 2, 5, 8, and 10 years was 25.7%, 24.3%, 25.7%, and 31.6%, respectively. In the present long-term high-participation follow-up study, LAGB is a safe and effective surgical treatment for morbid obesity. However, the high complication, re-operation, and long-term failure rates lead to the conclusion that LAGB should be performed in selected cases only, until reliable criteria for patients at low risk for long-term complications are developed.
Literature
1.
2.
Li Z, Bowerman S, Heber D. Health ramifications of the obesity epidemic. Surg Clin N Am. 2005;85:681–701.CrossRefPubMed
3.
Elder KA, Wolfe BM. Bariatric surgery: a review of procedures and outcomes. Gastroenterology. 2007;132:2253–71.CrossRefPubMed
4.
Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med. 2003;348:1625–38.CrossRefPubMed
5.
Finkelstein EA, Trogdon JG, Cohen JW, et al. Annual medical spending attributable to obesity: payer and service-specific estimates. Health Aff. 2009;28:w822–31.CrossRef
6.
Buchwald H. Bariatric surgery for morbid obesity: health implications for patients, health professionals and third-party payers. 2004 ASBS consensus conference statement. Surg Obes Relat Dis. 2005;1:371–81.CrossRefPubMed
7.
Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.CrossRefPubMed
8.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed
9.
Bult MJ, van Dalen T, Muller AF. Surgical treatment of obesity. Eur J Endocrinol. 2008;158:135–45.CrossRefPubMed
10.
Nguyen NT, Hinojosa M, Fayad C, et al. Use and outcome of laparoscopic versus open gastric bypass at academic medical centers. J Am Coll Surg. 2007;205:248–55.CrossRefPubMed
11.
Weller WE, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.CrossRefPubMed
12.
Sarr MG. The success of laparoscopic bariatric surgery—it has come of age and it is safe. Ann Surg. 2008;248:16–7.CrossRefPubMed
13.
Belachew N, Legrand MJ, Defechereux TH, et al. Laparoscopic adjustable silicone gastric banding in the treatment of morbid obesity. A preliminary report. Surg Endosc. 1994;8:1354–6.CrossRefPubMed
14.
Parikh MS, Laker S, Weiner M, et al. Objective comparison of complications resulting from laparoscopic bariatric procedures. J Am Coll Surg. 2006;202:252–61.CrossRefPubMed
15.
O'Brien P, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric surgery. Obes Surg. 2006;16:1032–40.CrossRefPubMed
16.
Weber M, Müller MK, Bucher T, et al. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004;240:975–82.CrossRefPubMed
17.
Suter M, Paroz A, Calmes JM, et al. European experience with laparoscopic Roux-en-Y gastric bypass in 466 obese patients. Br J Surg. 2006;93:726–32.CrossRefPubMed
18.
Galvani C, Gorodner M, Moser F, et al. Laparoscopic adjustable gastric band versus laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2006;20:934–41.CrossRefPubMed
19.
Gagner M, Milone L, Trelles N. Mortality after laparoscopic adjustable gastric banding: results from an anonymous questionnaire to ASBS members. Obes Surg. 2009;19:1657–63.CrossRefPubMed
20.
Steffen R, Biertho L, Ricklin T, et al. Laparoscopic Swedish adjustable gastric banding: a five-year prospective study. Obes Surg. 2003;13:404–11.CrossRefPubMed
21.
Zehetner J, Holzinger F, Triaca H, et al. A 6-year experience with the Swedish adjustable gastric band. Prospective long-term audit of laparoscopic gastric banding. Surg Endosc. 2005;19:21–8.CrossRefPubMed
22.
Martin LF, Smits GJ, Greenstein RJ. Treating morbid obesity with laparoscopic adjustable gastric banding. Am J Surg. 2007;194:333–43.CrossRefPubMed
23.
Naef M, Naef U, Mouton WG, et al. Outcome and complications after laparoscopic Swedish adjustable gastric banding: 5-year results of a prospective clinical trial. Obes Surg. 2007;17:195–201.CrossRefPubMed
24.
Balsiger BM, Ernst D, Giachino D, et al. Prospective evaluation and 7-year follow-up of Swedish adjustable gastric banding in adults with extreme obesity. J Gastrointest Surg. 2007;11:1470–7.CrossRefPubMed
25.
Steffen R, Potoczna N, Bieri N, et al. Successful multi-intervention treatment of severe obesity: a 7-year prospective study with 96% follow-up. Obes Surg. 2009;19:3–12.CrossRefPubMed
26.
Mittermair RP, Obermüller S, Perathoner A, et al. Results and complications after Swedish adjustable gastric banding—10 years experience. Obes Surg. 2009;19:1636–41.CrossRefPubMed
27.
Peternac D, Hauser R, Weber M, et al. The effects of laparoscopic adjustable gastric banding on the proximal pouch and the esophagus. Obes Surg. 2001;11:76–86.CrossRefPubMed
28.
Ceelan W, Walder J, Cardon A, et al. Surgical treatment of severe obesity with a low-pressure adjustable gastric band. Experimental data and clinical results in 625 patients. Ann Surg. 2003;237:10–6.CrossRef
29.
Suter M, Dorta G, Giusti V, et al. Gastric banding interferes with esophageal motility and gastroesophageal reflux. Arch Surg. 2005;140:639–43.CrossRefPubMed
30.
Klaus A, Gruber I, Wetscher G, et al. Prevalent esophageal body motility disorders underlie aggravation of GERD symptoms in morbidly obese patients following adjustable gastric banding. Arch Surg. 2006;141:247–51.CrossRefPubMed
31.
Klaus A, Weiss H. Is preoperative manometry in restrictive bariatric procedures necessary? Obes Surg. 2008;18:1039–42.CrossRefPubMed
32.
Milone L, Daud A, Durak E, et al. Esophageal dilation after laparoscopic adjustable gastric banding. Surg Endosc. 2008;22:1482–6.CrossRefPubMed
33.
Glättli A. Operative Adipositasbehandlung—Neue Fassung der Krankenpflegeleistungsverordnung (KLV). Schweiz Aerztezeitung. 2005;86:1450–1.
34.
Forsell P, Hallberg D, Heller G. A gastric band with adjustable inner diameter for obesity surgery: preliminary studies. Obes Surg. 1993;3:303–6.CrossRefPubMed
35.
Favretti F. Laparoscopic banding: selection and techniques in 830 patients. Obes Surg. 2002;12:385–90.CrossRefPubMed
36.
Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes and obesity-related health risk factors 2001. JAMA. 2003;289:76–9.CrossRefPubMed
37.
Solomon CG, Dluhy RG. Bariatric surgery: quick fix or long-term solution? N Engl J Med. 2004;351:2751–3.CrossRefPubMed
38.
O'Brien P, Dixon J, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding of an intensive medical program. A randomized trial. Ann Intern Med. 2006;144:625–33.PubMed
39.
Fried M, Hainer V, Basdevant A, et al. Inter-disciplinary European guidelines on surgery of severe obesity. Int J Obes. 2007;1:1–9.
40.
Burguera B, Agusti A, Arner P, et al. Critical assessment of the current guidelines for the management and treatment of morbidly obese patients. J Endocrinol Investig. 2007;30:844–52.
41.
SAGES Guidelines Committee. SAGES guideline for clinical application of laparoscopic bariatric surgery. Surg Endosc. 2008;22:2281–300.CrossRef
42.
Gastrointestinal surgery for severe obesity. NIH consensus development conference statement 1991, march 25–27. Am J Clin Nutr. 1992;55:615S–9S.
43.
Manterola C, Pineda V, Vial M, et al. Surgery for morbid obesity: selection of operation based on evidence from literature review. Obes Surg. 2005;15:106–13.CrossRefPubMed
44.
O'Brien PE, Dixon JB. Laparoscopic adjustable gastric banding in the treatment of morbid obesity. Arch Surg. 2003;138:376–82.CrossRefPubMed
45.
Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of morbid obesity: a systematic literature review. Surgery. 2004;135:326–51.CrossRefPubMed
46.
Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16:829–35.CrossRefPubMed
47.
Tolonen P, Victorzon M, Mäkelä J. 11-year experience with laparoscopic adjustable gastric banding for morbid obesity—what happened to the first 123 patients? Obes Surg. 2008;18:251–5.CrossRefPubMed
48.
Peterli R, Wölnerhanssen BK, Peters T, et al. Prospective study of a two-stage operative concept in the treatment of morbid obesity: primary Lap-Band followed if needed by sleeve gastrectomy with duodenal switch. Obes Surg. 2007;17:334–40.CrossRefPubMed
49.
Camerini G, Adami G, Marinari GM, et al. Thirteen years of follow-up in patients with adjustable silicone gastric banding for obesity: weight loss and constant rate of late specific complications. Obes Surg. 2004;14:1343–8.CrossRefPubMed
50.
Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22:947–54.CrossRefPubMed
51.
Rabkin RA. The duodenal switch is an increasing and highly effective operation for morbid obesity. Obes Surg. 2004;14:861–5.CrossRefPubMed
52.
Lanyon RI, Maxwell BM, Kraft AJ. Prediction of long-term outcome after gastric bypass surgery. Obes Surg. 2009;19:439–45.CrossRefPubMed
53.
Forsell P, Hallerbäck B, Glise H, et al. Complications following Swedish adjustable gastric banding (SAGB)—a long-term follow-up. Obes Surg. 1999;9:11–5.CrossRefPubMed
54.
Niville E, Dams A, Vlasselaers J. Lap-Band erosion: incidence and treatment. Obes Surg. 2001;11:744–7.CrossRefPubMed
55.
Szold A, Abu-Abeid S. Laparoscopic adjustable silicone gastric banding for morbid obesity: results and complications in 715 patients. Surg Endosc. 2002;16:230–3.CrossRefPubMed
56.
Nocca D, Frering V, de des Seguin Hons C, et al. Migration of adjustable gastric banding from a cohort study of 4236 patients. Surg Endosc. 2005;19:947–50.CrossRefPubMed
57.
Lattuada E, Zappa MA, Mozzi E, et al. Band erosion following gastric banding: how to treat it. Obes Surg. 2007;17:329–33.CrossRefPubMed
58.
Weiss H, Nehoda H, Labeck B, et al. Injection port complications after gastric banding: incidence, management and prevention. Obes Surg. 2000;10:259–62.CrossRefPubMed
59.
Miller K, Rettenbacher L, Hell E. Adjustments and leak detection of the adjustable silicone gastric band (ASGB) and Lap-Band adjustable gastric band (LAGB) system. Obes Surg. 1996;6:406–11.CrossRefPubMed
60.
Elias B, Staudt JP, van Vyne E. The technical approach in banding to avoid pouch dilatation. Obes Surg. 2001;11:311–4.CrossRefPubMed
61.
Zappa MA, Micheletto G, Lattuada E, et al. Prevention of pouch dilatation after laparoscopic gastric banding. Obes Surg. 2006;16:132–6.CrossRefPubMed
62.
Dargent J. Esophageal dilatation after laparoscopic gastric banding: definition and strategy. Obes Surg. 2005;15:843–8.CrossRefPubMed
63.
Burton PR, Brown W, Laurie C, et al. The effect of laparoscopic adjustable gastric bands on esophageal motility and the gastroesophageal junction: analysis using high-resolution video manometry. Obes Surg. 2009;19:905–14.CrossRefPubMed
64.
Dargent J. Isolated food intolerance after adjustable gastric banding: a major cause of long-term band removal. Obes Surg. 2008;18:829–32.CrossRefPubMed
65.
DeMaria EJ, Sugerman HJ, Meador JG, et al. High failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg. 2001;233:809–18.CrossRefPubMed
66.
Allen JW, Coleman MG, Fielding GA. Lessons learned from laparoscopic gastric banding for morbid obesity. Am J Surg. 2001;182:10–4.CrossRefPubMed
67.
Müller MK, Attigah N, Wildi S, et al. High secondary failure rate of rebanding after failed gastric banding. Surg Endosc. 2008;22:448–53.CrossRefPubMed
68.
Bueter M, Thalheimer A, Wierlemann A, et al. Reoperations after gastric banding: replacement or alternative procedures? Surg Endosc. 2009;23:334–40.CrossRefPubMed
69.
Metadata
Title
Graft Survival and Complications after Laparoscopic Gastric Banding for Morbid Obesity—Lessons Learned from a 12-Year Experience
Authors
Markus Naef
Wolfgang G. Mouton
Ursula Naef
Oliver Kummer
Beat Muggli
Hans E. Wagner
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 9/2010
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-010-0205-0

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